Acute thyroid hormone exposures in children: A French Poison Control Centers cohort study

Abstract

Purpose

Thyroid hormones are involved in many metabolic and physiological processes, including basal metabolism, thermoregulation, and heart rate; however, there is little information on acute exposure in children, with only a few cases reports or small cases series being available. Our study was undertaken to provide more information about the epidemiological and clinical course of L-thyroxine poisoning in a large pediatric population.

Methods

This multicenter historical cohort study was conducted using data from the French Poison Control Centers on the acute ingestion of thyroid hormone in children (0–18 years of age) between January 2018, 1st and December 2020, 31st.

Results

Of the 2,321 files analyzed, 1,307 cases were included. Toddlers (1–4 years) accounted for 72.8% of the cases. Oral ingestion was unintentional in 96% of the cases. The medicine was from a relative in 97.5% of cases. Only 10 (0.8%) children were symptomatic. No symptoms were reported below a dose of 6.6 μg/kg and some patients remained asymptomatic up to an alleged dose of 500 μg/kg. The symptoms reported were minor, transitory, and limited to tremor, agitation, diarrhea, vomiting, and tachycardia.

Conclusion

Acute L-thyroxine poisoning in children was mainly accidental (unintentional) and has only a few benign symptoms. The clinical outcome is good even if the alleged ingested dose is massive (up to 500 μg/kg).